Motor vehicle collisions are a neglected public health problem. Approximately 45% of all hospitalized trauma patients in the world have been injured in a motor vehicle collision (1) and an estimated 1.3 million people die in collisions annually. (2-4) Traffic collisions are among the 10 leading causes of death worldwide and are projected to become the third leading cause of disability-adjusted life years (DALYs) lost by 2020. (5) Adolescents and young adults (people aged 10-24 years) are at greater risk of being involved in motor vehicle collisions than older people (4,6-8) and men are at greater risk than women. (1,6,9) Motor vehicle collisions are also the leading cause of injury among children. (9) In low-income countries, children are most often injured in collisions involving minibuses, buses, trucks and other commercial vehicles. (9,10) The direct cost of motor vehicle collisions is roughly equivalent to 1% of the gross national product (GNP) in low-income countries and to 1.5% and 2% in middle- and high-income countries, respectively. (5,11,12) Although not all factors contributing to motor vehicle collisions are modifiable, many of them are. These include environmental factors such as road planning and traffic infrastructure, speed limits and the state of repair of driven vehicles, as well as human factors such as driving style and skills, state of alertness on the road, and the use of alcohol or drugs while driving. (3,12,13)

In many low-income countries, lack of money and human resources has impeded proper action to reduce motor vehicle collisions and injuries and mortality from traffic injuries has increased rapidly. (3,14-16) However, the declines observed in most high-income countries in traffic collisions and in road traffic injuries and deaths suggest that these problems and the resulting morbidity and mortality can be reduced in low- and middle-income countries as well. (16)

Nantulya & Reich (17) identified four reasons that explain why developing countries face a higher burden of motor vehicle collisions and injuries than developed countries: a proportionately higher increase in the number of motor vehicles, poor enforcement of traffic safety regulations, inadequate public health infrastructure and human resource capacity, and poor health-care services. Developing countries also have inadequate systems for collecting data on motor vehicle collisions and injuries and more fragmented response mechanisms. Consequently, both collisions and casualties are underreported. (12) Several studies conducted in low- and lower-middle-income countries have shown an association between the number of vehicles per capita and the number of motor vehicle collisions and injuries. (3,18,19) Furthermore, in low- and lower-middle-income countries, the reliability of the data aggregated by law enforcement and health agencies depends to some extent on the nature and severity of the injuries and their outcomes. (7) For example, police records might more accurately record fatal traffic injuries, whereas hospital data might be more reliable in tracking non-fatal injuries. It is possible that neither captures collisions involving minor injuries.

Kyrgyzstan

Located in central Asia, Kyrgyzstan is a former Soviet republic. Approximately 90% of its territory is mountainous. (20,21) Its population of over 5.3 million (22) is predominantly rural (65%) and over 30% is composed of children and adolescents. With a human development index of 0.604 (122nd among 179 countries) 2006, Kyrgyzstan is classified as a low-income developing country. (23,24)

The standardized rate of death from motor vehicle collisions in Kyrgyzstan remains higher than for the region of central Asia as a whole. It increased by more than 60% between 2000 and 2005 and reached 17.43 per 100 000 people in 2006. (25) Kyrgyzstan's traffic fatality rates are 30 times higher than those of western Europe and three times higher than eastern Europe and Asia. …

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